scholarly journals Efficacy of proximal femoral nail augmentation in unstable intertrochanteric fracture

2020 ◽  
Vol 6 (5) ◽  
pp. 1043
Author(s):  
Purushotham V. J. ◽  
M. Ayyub Khan ◽  
Navneeth Kumar
Keyword(s):  
Intertrochanteric Fracture ◽  
Femoral Fractures ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Cerclage Wire ◽  
Femoral Nail ◽  
Unstable Intertrochanteric Fracture ◽  
Male Patients ◽  
Modified Harris Hip Score ◽  
A Prospective Study

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong><span lang="EN-US">To assess the short term functional and radiological outcome of unstable intertrochanteric fracture fixation using proximal femoral nail with augmentation using Cannulated Cancellous (CC) screw or Stainless Steel (SS) wiring.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong><span lang="EN-US">A prospective study was conducted with 20 cases of unstable intertrochanteric femoral fractures from May 2017 to March 2019. Six females and fourteen male patients in the age group between 40 and 80 years were included in this study. There were 8 cases of AO31A2 and 12 cases of AO31 A3. Fracture were fixed by proximal femoral nail with augmentation by an additional CC screw or encirclage with SS wires to strengthen the lateral trochanteric wall.</span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">Fracture union was achieved in all cases with a mean period of 15.4 weeks. Patients were followed up for a period of 6 months. At the end of follow up the Modified Harris Hip Score was found to be more than 90 % in 16 cases.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusion:</span></strong><span lang="EN-US"> Augmentation of proximal femoral nail in unstable intertrochanteric fracture with additional screw or cerclage wire increases the efficacy and stability of construct, aiding union and expedition of time to union.</span></p>

scholarly journals Treatment of stable and unstable intertrochanteric fractures using proximal femoral nail and their functional assessment using modified Harris hip score

2018 ◽  
Vol 5 (1) ◽  
pp. 162
Author(s):  
Lakshya P. Rathore ◽  
Lokesh Gupta ◽  
Sanjay Thakur ◽  
Sandeep Vaidya ◽  
Devender Sharma ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Functional Evaluation ◽  
Intertrochanteric Fractures ◽  
Good Reduction ◽  
Non Union ◽  
Femoral Nail ◽  
Modified Harris Hip Score ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Intertrochanteric fracture is common injury and is found in both elderly and the young. Proximal femoral nail (PFN) has been in widespread use for the same in the recent past. There are advocates both for and against this implant. The aim was to study the results of PFN in the treatment of intertrochanteric fractures and their functional evaluation using the modified Harris hip score.</p><p class="abstract"><strong>Methods:</strong> A prospective study done on 104 patients operated for intertrochanteric fractures with PFN. Patients were followed up at 6 weekly intervals and evaluated at each visit using the modified Harris hip score (HHS).<strong></strong></p><p class="abstract"><strong>Results:</strong> The study consisted of 104 patients aged from 36 to 96 years with average age of 67.8 years. Most patients belonged to 60-80 years category. Malunion was observed in three patients (2.8%) and non union was not seen in any patient. Excellent to good results were seen in 73% patients 18% patients had a fair outcome, 7.7% had poor and 2% patients had very poor outcome.</p><p class="abstract"><strong>Conclusions:</strong> PFN is a good implant for intertrochanteric fracture treatment that demands a sound technique and a good reduction prior to insertion. The assessment of results using HHS has been too similar to those obtained using Kyle’s criteria in the previous studies, proving its role in the same.</p><p> </p>

scholarly journals Management of Subtrochanteric Fracture Femur- by ProximalFemoralNailing

2022 ◽  
Vol 8 (1) ◽  
pp. 132-140
Author(s):  
Girish Sahni
Keyword(s):  
Excellent Result ◽  
Tertiary Care ◽  
Subtrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Subtrochanteric Fractures ◽  
Femoral Nail ◽  
One Year ◽  
Modified Harris Hip Score ◽  
A Prospective Study

Background: Numerous variations of intramedullary nailing have been evolved over the years for stable fixation and early mobilisation of subtrochanteric fracture, out of which one is proximal femoral nail. Aims and objectives –We conducted this study with an objective to evaluate the results of internal fixation of subtrochanteric fractures of the femur with proximal femoral nail – AO type Design.Methods:This was a prospective study carried out at our tertiary care institute on 30 patients who had suffered subtrochanteric fracture and were subsequently treated with a proximal femoral nail (PFN). Proximal femoral nail was inserted through the tip of greater trochanter. All patients were followed up for a period of one year; at an interval of 3 months and during each follow-up visit for the functional outcome by modified Harris Hip Score, was assessed in the form of walking, squatting, sitting and rising from chair.Results:Modified Harris hip score was used for the evaluation of results in our study which showed excellent result in 21 patients (70%), good results in 3 cases(10%), fair results in 3 patient (10%) and poor results in 3 cases(10%). The mean Harris hip score in our study was 90.6.Conclusion:PFN is an intramedullary load sharing implant. Reduction and management of subtrochanteric fractures is challenging in traumatology. Proximal femoral nailing spanning whole femur with proximal and distal locking appears to be a satisfactory implant in management of fractures of subtrochanteric femur.

AO/OTA 31A2 and 31A3 Intertrochanteric Fractures Managed by Proximal Femoral Nail Antirotation (PFNA)

2021 ◽  
Vol 15 (10) ◽  
pp. 2616-2618
Author(s):  
Zamir Hussain Tunio ◽  
Rizwan Ali Jhatiyal ◽  
Muhammad Azeem Akhund ◽  
M. Kashif Abbasi ◽  
S. Muhammad Ali ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Psychiatric Disease ◽  
Unstable Fracture ◽  
Intertrochanteric Fractures ◽  
Femoral Nail ◽  
Intramedullary Device ◽  
Unstable Intertrochanteric Fracture ◽  
Proximal Femoral Nail Antirotation

Aim: To study the clinical and radiological outcome of unstable intertrochanteric fracture AO/OTA 31A2, 31A3 fixed by proximal femoral nail antirotation Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopedic Surgery and Traumatology, Pir Abdul Qadir Shah Jilani Institute of Medical Sciences, Gambat, Sindh from 1st January 2016 to 31st December 2019. Methodology: Forty four cases having intertrochanteric fracture AO/OTA 31A2, 31A3 with age ranging from 18 year to 55 year of either gender were selected; patients having close fracture, who were willing were included in the study, while patients older than 55 year and younger than 18 year, AO/OTA 31A1 fracture, open fracture, bilateral injuries, smoker, alcoholic, drug addicted, poly-trauma, pathological fracture and history of poor compliance, psychiatric disease were excluded. Results: There were 26(59.09%) males and 18(40.91%) females with mean age was 41.3±7.7 years. Regarding classification; AO/OTA 31A2 were 33 (75%), and 31A3 were 11 (25%). Mean time for union was 18.5±3.55 weeks. The average time of follow-up was 48.5±6.6 weeks. Harris Hip Score was excellent (90-100) in 31(70.45%), good (80-89) in 7(15.91%), fair (70-80) in 3 (6.81%) and poor (<70) in 3 (6.81%). Conclusion: Intramedullary device proximal femoral nail antirotation can be labelled as implant of choice for unstable intertrochanteric fractures AO/OTA 31A2, 31A3, with fruitful clinical and radiological outcomes, and with fewer complications. Hip Harris score was excellent-good in 86% of the patients. Key words: Proximal femoral nail antirotation (PFNA), AO/OTA 31A2, 31A3, Intertrochanteric, unstable fracture

scholarly journals A Comparative Study of Unstable Intertrochanteric Fracture by Proximal Femoral Nail versus Proximal Femoral Nail Anti-Rotation among Adult Patients

2021 ◽  
Vol 6 (1) ◽  
pp. 27-33
Author(s):  
Santosh Kumar Singh ◽  
Raj Kumar Bhartiya
Keyword(s):  
Comparative Study ◽  
Intertrochanteric Fracture ◽  
Adult Patients ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Functional Evaluation ◽  
Excellent Outcome ◽  
Femoral Nail ◽  
Significant Difference ◽  
Unstable Intertrochanteric Fracture

Objective: To compare unstable intertrochanteric fracture by proximal femoral nail versus proximal femoral nail anti-rotation among adult patients. Methods: This was a comparative study. Patients were randomized into 2 groups: Proximal Femoral Nail Anti-rotation (n=30) and Proximal femoral nail group (n=30). Singh’s index was used to grade the radiographs for the degree of osteoporosis. Functional evaluation was done at 3 months, 6 months, 9 months and 12 months by using Harris Hip Score. Results: Majority of patients in both PFN (60%) and PFNA (70%) were between 61-70 years. More than half of patients of PFN (56.7%) and 43.3% of PFNA were males. The operative time was 84.00±9.39 minutes among patients of PFN and 61.03±5.75 minutes among patients of PFNA with significant difference between the groups. Singh’s grade III was most common among patients of both PFN (36.7%) and PFNA (36.7%). There was no significant (p>0.05) difference in Harris Hip score between the groups at all the time periods. Excellent outcome was in 63.3% patients of PFNA and in 46.7% patients of PFNA. Good outcome was in 33.3% patients of PFN and in 10% of PFNA. Conclusion: The study suggests that both PFN and PFNA perform well, showing equally good functional outcomes following fixation of unstable trochanteric fractures. PFNA offers no significant benefits over PFN in terms of post-operative complications. Keywords: Unstable intertrochanteric fracture, Proximal femoral nail, Proximal femoral nail anti-rotation.

scholarly journals Functional and Radiological Outcome of Unstable Intertrochanteric Fracture in Old Age Treated with Proximal Femoral Nail Antirotation-2

2021 ◽  
Author(s):  
OP Jamshad ◽  
Jacob Mathew ◽  
Raju Karuppal
Keyword(s):  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
Intertrochanteric Fractures ◽  
Biological Reduction ◽  
Neck Shaft Angle ◽  
Femoral Nail ◽  
Unstable Intertrochanteric Fracture ◽  
Shaft Angle ◽  
The Mean ◽  
Proximal Femoral Nail Antirotation

Introduction: Intertrochanteric fractures are prevalent in the elderly, which leave patients with functional restrictions. Proximal Femoral Nail Antirotation-2 (PFNA) was developed to achieve better fixation strength, particularly in the presence of osteoporotic unstable intertrochanteric fractures. Aim: To evaluate the role and result of PFNA-2 in the treatment of unstable intertrochanteric fractures in geriatric patients. Materials and Methods: A prospective analytical study was conducted in 35 patients with unstable intertrochanteric fractures. They were followed-up clinically and radiologically for one year. The quality of fixation was assessed, by neck-shaft angle and Tip Apex Distance (TAD). A functional assessment was done with the Harris Hip Score (HHS). Results: The mean follow-up period was 13 months (range, 12-14). The mean age of patients was 65.6 years and the majority were female patients (62.85%). Functional results according to modified HHS were found to be excellent in 6 (17.1%) patients, good in 14 (40%) patients, fair in 12 (34.3%) patients and poor in 3 (8.6%) patients. The average HHS in this study was 81.6. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 16.0. Conclusion: PFNA-2 helps in achieving biological reduction and good stability which enables early mobilisation and prevention of excessive collapse. A good functional outcome could be achieved when the radiological parameters are restored, i.e., TAD <25 mm and neck-shaft angle difference <5° (compared to the opposite side).

scholarly journals COMPARATIVE STUDY OF HEMIREPLACEMENT ARTHROPLASTY WITH BIPOLAR PROSTHETIC AND PROXIMAL FEMORAL NAIL (PFN) IN UNSTABLE INTERTROCHANTERIC FRACTURE OF FEMURE: INTERVENTIONAL PROSPECTIVE RANDOMIZED STUDY

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Sawai Singh ◽  
Raghuveer Meena
Keyword(s):  
Randomized Study ◽  
Proximal Femoral Nail ◽  
Harris Hip Score ◽  
P Value ◽  
Bipolar Group ◽  
Femoral Nail ◽  
Keywords Hip ◽  
Unstable Intertrochanteric Fracture ◽  
Keywords Hip Arthroplasty ◽  
Intertrochanteric Femur Fracture

Background: Intertrochanteric femur fracture incidence has increased due to increased life expectancy and osteoporosis. Methods- The present study was prospectively carried out in 60 consecutive patients of Fracture Intertrochanter Femur and treated with Hemiarthroplasty with Cemented Bipolar Prosthesis and Proximal Femoral Nail. Results: The age of the patients in present study was in range of 60 - 80 years. There was a preponderance of female in present study in both groups. The mean duratioin of surgery in the Bipolar group (91.24±9.21Minutes) was much More That In PFN (53.12 ±6.02Minutes) Group. All patients of Bipolar group was discharged between 4 to 9 days and in PFN group 4 to 12 days after surgery. The average harris hip score in PFN group is 87.32±4.13 and in Bipolar group is 85.02±7.92. Final functional outcome were better in PFN group (P value 0.01) than by Bipolar group and significant. Conclusion: The outcomes of the stable fractures treated with either Bipolar or PFN were similar. Unstable comminuted fractures treated with Bipolar showed significantly better outcomes with all patients having good results. Keywords: Hip Arthroplasty, PFN, Complication

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